Montana Proposes a Bill that Would Allow Doctors to Opt Out of Certain Medical Procedures

A woman comes into an emergency room and has a abrupt placenta. Clinicians assemble a team to perform a blood transfusion and things are chaotic in the ER, a scenario drawn by Rep. Laura Smith. There is still a fetal heartbeat, but to save the mother’s life they have to remove tissue from the uterus.

“Am I understanding Section 9 correctly that everyone must stop what they are doing to sign papers to say they can attend?” Smith, D-Helena, asked Dr. Nathan Allen, an emergency room physician at the Billings Clinic, who opposed a bill being considered by the Montana Legislature.

Allen said based on how abortion is defined in Montana, “expected written consent from all employees will be required in advance.”

The doctor was one of nearly two dozen professionals and representatives from medical organizations across the state who testified against House Bill 303, which would provide protections for physicians and entities who object to attending health care services on a conscience basis, defined as “ethical, moral or religious beliefs or principles.”

Proponents argue that the bill would help with the current shortage of medical workers, since workers who are reluctant to have procedures against their faith would not have to do them.

“Montana physicians enjoy serving our diverse communities, but they may have conscientious objections to a particular procedure, and no one should be forced to choose between their profession and their faith,” said Dr. David Ingram, an anesthetist from Kalispell.

Rep. Amy Regier, R-Kalispell, chair of the House Judiciary Committee and sponsor of the bill, listed several procedures that “include objections to lifestyle and electoral procedures and treatments”:

• Euthanasia,
• dispensing marijuana and opioids,
• Gene editing or other genetic manipulations on children in utero abortion procedures and
• Operations that remove healthy body parts from minors or that result in permanent sterilization.

But opponents said medical staff already have the ability to opt-out of procedures and the bill would violate both federal law and patients’ interests.

The Emergency Medical Treatment & Labor Act (EMTALA) requires hospitals that accept Medicaid to provide medical care in emergency situations.

Supporters point to language in the bill that would protect people who need emergency care. Those advocates pointed to a section in the bill that federal law would require said healthcare facilities to provide emergency medical treatment to all patients.

Ezekiel Clark, a transgender man who spoke out against it, said he was concerned if something happened that would require medical attention while he was recovering, such as going to the shooting range or hiking in the mountains, a medical provider could refuse to care for him under this law.

“It might not mean anything to someone who doesn’t know me, but my wife, family and friends would be deprived of my father’s quips, slick dance moves, unwavering loyalty and unwavering devotion,” he said.

Rep. Zooey Zephyr, D-Missoula, asked Governor if staff, including a receptionist, could refuse gender-affirming care. Zephyr is the first trans woman to be elected to the state legislature.

Governor said the bill is about the process, not the person.

Regier said five other states allow medical professionals to conscientious objector, including Illinois, Arkansas, Mississippi, South Carolina and Ohio.

Rep. Laurie Bishop, D-Livingston, said in a quick search that Illinois’ conscientious objection allows the facility to plan for a provider’s objection to the provision of a service and that a referral would be required. But opponents said Montana’s bill would not have to issue a warning or refer clients to other healthcare professionals who would provide the service they want.

There were twice as many opponents as supporters.

Opponents not only objected to the content of the bill, but also to the procedure for setting up the hearing. They said the hearing had not been properly scheduled with three legislature days notice as Monday’s session was announced on Friday afternoon.

The rules committee will meet Tuesday morning at the request of minority leader Rep. Kim Abbott, D-Helena. Rep. Casey Knudsen, R-Malta, who is also on the House Judiciary, will report from the House of Representatives session.

This story originally appeared in The Daily Montanan, which can be found online at dailymontanan.com.